Mental illness is a leading cause of disability in the United States. About 13 million adults have a debilitating mental illness each year, and almost half of all adults will be affected by mental illness in their lifetime. Five percent of adults have a serious mental illness.About one in five children are affected by a mental health disorder with severe impairment in their lifetime.

More than 8 percent of Texas adults report current depression, and 5.2 percent report serious psychological distress. In 2011, almost 30 percent of Texas high school students reported they felt sad or hopeless almost every day for at least two weeks. Suicide is a leading cause of death among Texans under 35 years.

More than 66,000 Texans were cared for in state-funded substance abuse treatment programs in 2010. Substance use is common in Texas students (grades 7-12), with 62 percent reporting they had used alcohol and 17.2 reporting inhalant abuse. Despite significant legislation to curtail drinking and driving, almost 40 percent of Texas driving fatalities are still associated with alcohol use.

In 2009, 23 percent of the adult offenders in Texas state prisons, on parole, or on probation were current or former clients of the Texas public mental health system. A Texan with a serious mental illness is eight times more likely to be in a jail than in a hospital or treatment program, at a cost of $50,000 a year. A person in jail without a mental illness costs the state about $22,000 annually.

Mental illness is also strongly associated with high-risk behaviors such as alcohol, tobacco, and illicit drug use, and results in conditions such as obesity. U.S. mental health costs were estimated to be $57.5 billion in 2006 including the cost of mental health care and the indirect costs of disability caused by mental illness. One recent study estimates that Texas state dollars spent on mental health exceed $13 billion each year.

Mental health treatment costs in the United States totaled almost $9 billion in children in 2006; Medicaid covered more than one-third of these costs.

Proper care for persons with mental illnesses saves costs associated with the cycle of incarceration, homelessness, and so forth. Assessing the return on investment connected with mental health and substance abuse care is complex because there are many different diagnoses, and the disability caused by each and the treatment plans vary greatly. In 2003, depression cost U.S. employers $44 billion in lost productivity alone. One employee assistance program in California showed a return on investment of $5.17 to $6.47 for every dollar spent on employee assistance for a mental health problem.

While Texas has recently made significant investments in community mental health services, we still rank 50th in state public mental health funding per capita.

NASHVILLE-In December, Tennessee Gov. Bill Haslam, a Republican, got the deal he wanted from the Obama administration: Tennessee would accept more than $1 bi...

Texas Medical Association's insight:

TMA says:

Texas physicians want to ensure all Texans have access to coverage and, more important, have access to physicians and other health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering, and even death.

That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. (See adjacent chart.) TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care. Any Texas-style solution expanding access must:

• Draw down all available federal dollars to expand access to health care for poor Texans;

• Give Texas the flexibility to change the plan as our needs and circumstances change;

• Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;

• Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;

• Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; and

• Continue to improve due process of law for physicians and other providers in Texas as it relates to the Office of Inspector General.

Here’s a modest proposal for the Texas Legislature: In the coming legislative session, try to end with the same number — or even fewer laws — than you began with. Repeal some regulations, loosen some licensing requirements.

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Texas Medical Association's insight:

TMA Says:

Promote Government Efficiency and Accountability by Reducing Medicaid Red Tape

Administrative hassles not only detract from a physician’s ability to provide needed care, they also drive up overhead costs, ultimately making the meager Medicaid payments too low for many physicians to put up with the tangle of red tape.

Perspective from The New England Journal of Medicine — Medicaid Payments and Access to Care

Texas Medical Association's insight:

TMA says:

Ensure competitive Medicaid and CHIP payments for physicians

Physicians want to take care of Texans who rely on Medicaid coverage for their care. Unfortunately because of the red tape and bureaucratic hassles coupled with low payment rates, many physicians struggle to continue to see their Medicaid patients. (See Section 4: Promote Government Efficiency and Accountability by Reducing Medicaid Red Tape for details.)

Medicaid is a state- and federally funded health care program that provides low-income patients access to essential health care services. For every dollar Texas invests in Medicaid, the federal government contributes another $1.40. Without Medicaid, millions more Texans would be uninsured: As of June 2014, Medicaid covered nearly 3.8 million Texans. To qualify, patients must have a low income, but being poor doesn’t always mean a patient will qualify for the program. For example, low-income childless adults are not eligible in Texas even if their income meets the state’s Medicaid income requirements. Most Medicaid recipients in Texas are children, pregnant women, or disabled.

Texas allocated $56 billion in all funds to Texas Medicaid for budget years 2014-15; the state’s share was $22.1 billion, and the federal government paid $33.9 billion. While most enrollees (75 percent) are pregnant women and children, they account for only about 40 percent of the program’s costs. Seniors and patients with disabilities make up the other 25 percent of the patient population but account for 60 percent of the costs. In 2013, the Texas Legislature enacted numerous reforms to reduce total Medicaid expenditures by $961 million, including authorizing further expansion of Medicaid HMOs, improving birth outcomes, and restructuring the medical transportation program.

The Children’s Health Insurance Program (CHIP) provides health insurance to low-income children who do not qualify for Medicaid. Like Medicaid, the costs are shared between the state and federal government: In 2014, the federal government paid 70 percent of Texas’ CHIP costs. The Affordable Care Act (ACA) reauthorized CHIP through 2019 and approved funding for the program through September 2015. Pending continued funding, beginning in federal fiscal year 2016, the ACA will increase the CHIP federal matching amount another 23 percent, meaning Texas’ cost-sharing would drop from 30 percent to 7 percent. As of April 2014, some 500,000 low-income children were enrolled. To qualify, a family of four may not earn more than $47,700 (in 2014).

For physicians, Medicaid and CHIP are typically the lowest payers. They often do not cover the basic cost of providing the service. On average, Medicaid pays 73 percent of Medicare and about 50 percent of commercial insurance payments. In 2010 and 2011, the state cut already-meager physician payments another 2 percent.

Recognizing the inadequacy of Medicaid payments and the need to pay better to expand access to care, the ACA gave primary care physicians a temporary reprieve from low Medicaid rates. The act increased Medicaid payments to Medicare parity for primary care services provided by eligible physicians from Jan. 1, 2014, to Dec. 31, 2015. The federal government provided 100 percent of the funding to pay for the higher rates. CHIP services were excluded from the rate increase as were subspecialists.

Without action by Congress — or the Texas Legislature — the higher payments will soon expire. As federal action appears unlikely, Texas lawmakers should invest the necessary resources to improve appropriate and timely access to medical services for Medicaid patients not only by maintaining higher payments for primary care physicians, but also by ensuring competitive physician payment rates for subspecialists and the CHIP program.

If lawmakers cut physicians’ payments further or fail to invest in a robust physician network, millions of Medicaid recipients will have an enrollment card but fewer physicians caring for them, driving patients to use more costly emergency departments.

More than two dozen Republican congressmen are urging the U.S. Supreme Court to take up a lawsuit gunning for the healthcare reform law's Independent Payment Advisory Board.

Texas Medical Association's insight:

TMA says:

Repeal the Independent Payment Advisory Board

Replacing the SGR and removing administrative penalties will be meaningless unless Congress also repeals the Independent Payment Advisory Board (IPAB). Leaving both in place would create cruel and unusual double jeopardy for physicians who want to care for senior citizens and military families. The ACA created a 15-member IPAB designated to recommend measures to reduce Medicare spending if costs exceed targeted growth rates.

The ACA prohibits the panel from recommending changes to eligibility, coverage, or other factors that drive utilization of health care services. This means the board will have only one option — cut payments. And through 2019, hospitals, Medicare Advantage plans, Medicare prescription drug plans, and health care professionals other than physicians are exempt. This means the board has only one option — cut Medicare payments to physicians. Cuts the board recommends will automatically take effect, unless Congress acts to suspend them.

As we’ve seen with the SGR, it’s obvious that cuts the IPAB enacts will devastate Medicare beneficiaries’ ability to find physicians to care for them. The issue of Medicare spending for 3.2 million Texans is too important to be left in the hands of an unaccountable board that makes decisions based solely on cost.

New government data released Thursday about tobacco use finds electronic cigarette use among high school students is on the rise, prompting calls for tougher regulation by medical organizations and anti-smoking advocates.

While the number of middle school students who reported using an e-cigarette in the last 30 days remained the same at 1.1% in 2013, the number of high school students who said they had used the devices jumped from 2.8% in 2012 to 4.5% in 2013. That percentage was triple the high-school use rate reported in 2011 of 1.5%.

Texas Medical Association's insight:

TMA Says:

While cigarettes, cigars, and smokeless tobacco (chewing tobacco and snuff) are the most widely used tobacco products, some new products are attracting the interest of minors. Electronic cigarettes or “e-cigarettes” are widely accessible and growing in popularity. Several states have already passed legislation to include e-cigarettes in nonsmoking laws or to restrict the sale of e-cigarettes to minors.

TMA is calling on lawmakers to restrict the purchase of e-cigarettes by minors, adopt appropriate regulations for e-cigarettes, and ensure the current smoking prohibitions include e-cigarettes. Physicians are concerned that the use of e-cigarettes by minors could be a pathway to future tobacco use and nicotine addiction.

[Huffington Post] [Huffington Post] Competition for the biggest waste of time in Washington is fierce, but certainly the annual "doc fix" exercise deserves to be in the running. Medicare's Sustainable Growth Rate was created in an attempt to control Medicare's costs by tying the ...

Texas Medical Association's insight:

TMA says:

✓ Repeal the broken Sustainable Growth Rate (SGR) formula. Enact a rational Medicare physician payment system that works and is backed by a fair, stable funding formula.

✓ Fix the broken SGR formula before giving additional payment increases to any other provider in Medicare.

✓ Pass the Medicare Patient Empowerment Act, giving physicians the ability to contract directly for any and all Medicare services.

This report provides an overview of Medicaid financing and Medicaid spending and enrollment growth with a focus on state fiscal years 2014 and 2015 (FY 2014 and FY 2015.) Findings are based on interviews and data provided by state Medicaid directors as part of the 14th annual survey of Medicaid directors in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured (KCMU) survey with Health Management Associates (HMA). Findings examine changes in

Here's another reason to get your kids off the couch and make them run around instead: It will help them think better.

Texas Medical Association's insight:

TMA Says:

Improved physical health in students has been linked to academic success. Conversely, children with obesity are more prone to absences and lower grades. In the United States, students who are physically active at least 60 minutes on most days, play on at least one sports team, or watch fewer than three hours of television per day consistently earn “mostly A’s.” Unfortunately, the physical health of our students has been further compromised by the Texas Legislature’s action to reduce health education requirements.

The obesity epidemic, and the ever-younger age groups it strikes, threatens Texas’ physical and fiscal health. Texas’ continually expanding waistline correlates with increased health care costs. Obesity is responsible for 27 percent of the growth in health care spending. Treating obese patients costs 37 percent more than treating normal-weight patients. And over the course of a patient’s lifetime, the per-person costs of obesity appear to be the same as the costs for smoking.37

The rise in overweight and obesity also is affecting the bottom line of Texas employers. In 2009, the Texas Comptroller’s Office found that obesity costs Texas businesses an estimated $9.5 billion due to higher employee insurance costs, absenteeism, and other effects. Left unchecked, obesity could cost employers $32.5 billion annually by 2030.38

TMA recognizes there is no single solution to preventing or addressing the negative impacts of obesity. Physicians, communities, parents, schools, and workplaces must pursue multiple, scientifically proven approaches. Each must identify potential barriers to implementing local approaches for dealing with this growing crisis. Our legislative leaders can also play an important role by creating and promoting good health care policy that improves the health of Texans.

In addition to reducing costs of existing administrative requirements, TMA wants to prevent the government from placing new burdens on physician practices, such as electronic funds transfer fees.

TMA became aware of certain companies that were acting as middlemen in electronic funds transfer (EFT) transactions. One company told physicians they must “act quickly” to “continue to receive payments” through EFT at a charge of 1.5 percent per claim.

The most scurrilous aspect of an EFT percentage fee is that the amount paid may increase greatly with no corresponding increase in the actual cost of funds transfer. For instance, at 1.5 percent, an EFT for a $200 service would cost $3, while an EFT for a $10,000 surgery would be $150. According to the U.S. Treasury, it costs the government “10.5 cents to issue an EFT payment.” To charge even $3 is an outrageous overcharge for an EFT. TMA opposes charging physicians percentage fees for using EFTs.

Texas lawmakers are exploring ways the state could provide more access to health care for 1.9 million uninsured poor people without acquiescing to guidelines set under the Affordable Care Act, sometimes referred to as Obamacare.

Texas Medical Association's insight:

Texas physicians want to ensure all Texans have access to coverage and, more importantly, access to physicians and health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance results often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering and even death. That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania . TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care.

Any Texas-style solution expanding access must:

Draw down all available federal dollars to expand access to health care for poor Texans;Give Texas the flexibility to change the plan as our needs and circumstances change;Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; andContinue to uphold and improve due process of law for physicians in Texas as it relates to the Office of Inspector General.

Texas physicians want to ensure all Texans have access to coverage and, more importantly, access to physicians and health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance results often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering and even death. That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care.

Any Texas-style solution expanding access must:

Draw down all available federal dollars to expand access to health care for poor Texans;Give Texas the flexibility to change the plan as our needs and circumstances change;Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; andContinue to uphold and improve due process of law for physicians in Texas as it relates to the Office of Inspector General.

Inside a cluttered downtown apartment that she shares with a cat, the 57-year-old woman is in the midst of a near-meltdown.

Texas Medical Association's insight:

In 2009, 23 percent of the adult offenders in Texas state prisons, on parole, or on probation were current or former clients of the Texas public mental health system. A Texan with a serious mental illness is eight times more likely to be in a jail than in a hospital or treatment program, at a cost of $50,000 a year. A person in jail without a mental illness costs the state about $22,000 annually.

Young Americans are becoming less aerobically fit with every year, with only 42 percent of 12- to 15-year-olds in a new study making it into the “healthy fitness zone.”

Texas Medical Association's insight:

Overweight and obesity contribute to diabetes, hypertension, heart disease, cancer, and stroke. Texas has an easy-to-see obesity crisis. Some 66 percent of Texas adults are overweight or obese; the United States average is 63 percent. During the past three decades, obesity rates in children have more than tripled in the country. Today, 32 percent of Texas children (ages 10-17) are obese.

Improved physical health in students has been linked to academic success. Conversely, children with obesity are more prone to absences and lower grades. In the United States, students who are physically active at least 60 minutes on most days, play on at least one sports team, or watch fewer than three hours of television per day consistently have “mostly A’s.”

The patient-centered medical home (PCMH) is an effective way to cut costs and raise quality, a new PCPCC report says.

Texas Medical Association's insight:

TMA says:

Promote the patient-centered medical home for every Texan

Consider that the costliest 1 percent of patients in the United State account for more than 20 percent of the nation’s health care spending. They are older patients with cancer, diabetes, heart disease, and other serious and chronic conditions. Many have multiple health problems and may not have relatives who can help with their care.

As public and private payers look for ways to reduce costs, improve patient outcomes, and ease barriers to access, they are turning to models of care that increase economic efficiencies and enhance patient care. One of these is the patient-centered medical home (PCMH). A PCMH is a primary care physician or physician-led team who ensures that patient care is assessable, coordinated, comprehensive, patient-centered, and culturally relevant. The physician or team directly provides, coordinates, or arranges health care or social support services as indicated by the patient’s individual medical needs and the best available medical evidence. The model uses a team-based approach, with the patient’s primary care physician leading the coordination of care. Trained teams and well-constructed electronic health records are keys to a successful PCMH.

TMA supports the use of the PCMH model in Medicare, Texas Medicaid, and commercial insurance plans. Given the budget constraints Texas faces and a growing population with unique health care needs, the PCMH offers the potential for Medicaid cost savings as well as improved patient outcomes and physician and provider satisfaction.

In recent years, numerous states have implemented PCMH initiatives that engage both private and public payers. While each program design was unique and each measured success differently, the evidence indicates the model improves outcomes and reduces costs.

High schoolers are more likely to smoke e-cigs than regular cigarettes

Texas Medical Association's insight:

TMA Says:

While cigarettes, cigars, and smokeless tobacco (chewing tobacco and snuff) are the most widely used tobacco products, some new products are attracting the interest of minors. Electronic cigarettes or “e-cigarettes” are widely accessible and growing in popularity. Several states have already passed legislation to include e-cigarettes in nonsmoking laws or to restrict the sale of e-cigarettes to minors.

TMA is calling on lawmakers to restrict the purchase of e-cigarettes by minors, adopt appropriate regulations for e-cigarettes, and ensure the current smoking prohibitions include e-cigarettes. Physicians are concerned that the use of e-cigarettes by minors could be a pathway to future tobacco use and nicotine addiction.

ATLANTA, Dec 11 (Reuters) - More than 16 million children in10 states and the District of Columbia have legal access toelectronic cigarettes, according to a federal study released onThursday.The underage

Texas Medical Association's insight:

TMA says:

While cigarettes, cigars, and smokeless tobacco (chewing tobacco and snuff) are the most widely used tobacco products, some new products are attracting the interest of minors. Electronic cigarettes or “e-cigarettes” are widely accessible and growing in popularity. Several states have already passed legislation to include e-cigarettes in nonsmoking laws or to restrict the sale of e-cigarettes to minors.

TMA is calling on lawmakers to restrict the purchase of e-cigarettes by minors, adopt appropriate regulations for e-cigarettes, and ensure the current smoking prohibitions include e-cigarettes. Physicians are concerned that the use of e-cigarettes by minors could be a pathway to future tobacco use and nicotine addiction.

The Texas physicians' group has been in the forefront of physician opposition to ICD-10, remaining so even after HHS issued its final rule in August to comply with the congressional mandate.

Texas Medical Association's insight:

TMA says:

Forced adoption of International Classification of Diseases, 10th revision (ICD-10), is an excellent example of a costly regulation that will disrupt practice operations. ICD-10 is a 20-year-old boondoggle of a system that will help only health care researchers. All physicians, hospitals, providers, and insurance companies must shift from ICD-9 to ICD-10 by Oct. 1, 2015.

The ICD-10 mandate will create significant burdens on the practice of medicine with absolutely no direct benefit to individual patient care. It is a huge weight to place on physicians when they face numerous other administrative hurdles, including implementing and achieving meaningful use of electronic health records (EHRs), meeting quality measures under Medicare’s Physician Quality Reporting System (PQRS) and other programs, the impending creation of accountable care organizations in Medicare, and more. The timing of the transition could not be worse, as many physicians already are spending significant time and resources implementing complex EHRs in their practices.

ICD-10 is old technology developed during the 1980s and not designed to work in the current electronic world. A new version of the codes, ICD-11, could come as early as 2017. It is being designed for use with EHRs and the Internet, and should be more user-friendly than ICD-10.

After three deadline extensions, TMA is asking the Centers for Medicare & Medicaid Services (CMS) to delay ICD-10 permanently until ICD-11 or another appropriate replacement for ICD-9 is ready for widespread implementation.

MGMA sends letter to Congress urging them to permanently repeal the Sustainable Growth Rate (SGR) during its 2014 post-election session.

Texas Medical Association's insight:

TMA Says:

Medicare patients should feel anything but secure about the future of their health care. Physicians are key to delivering health care services and are the foundation of the Medicare program. Without a robust network of physicians to care for the millions of patients dependent on Medicare, the program will not work.

We all recognize the value that hospitals, nursing homes, home health services, durable medical equipment vendors, and other health care providers give to Medicare patients. However, over the past decade, they all have received annual payment increases, while physicians have not.

Congress must repeal the flawed SGR formula permanently and replace it with a rational Medicare physician payment system that works and is backed by a fair, stable funding formula. Congress should create a bipartisan subcommittee to develop a comprehensive list of viable pay-fors to cover the cost.

Medicare's programs have lost their focus and are not providing the promised timely, actionable feedback. Instead of quality-improvement programs, they have become bureaucratic data-reporting programs.

Texas Medical Association's insight:

TMA believes the patient-physician relationship must be preserved regardless of patients’ health conditions, ethnicity, economic circumstances, demographics, or treatment compliance patterns. Unfortunately, many pay-for-performance strategies, commonly referred to as “value-based payment models,” that intend to contain health costs could undermine this relationship. These strategies have proliferated in both commercial and government health programs. The ACA encourages payment based solely on outcomes and mandates pay adjustments for all physicians. This often selectively penalizes physicians who treat disadvantaged patients.

Value-based payment models that do not risk-adjust properly for patients’ health status and those that rely solely on claims data for evaluation of care will likely hurt the patient-physician relationship. This is particularly true if patient risk factors, chronic conditions, compliance, health disparities, and culturally competent care are not factored into the physician’s performance profile. For example, many physicians are rated on how many of their patients obtain screening mammograms or colonoscopies at appropriate times; those ratings, and their payments, are hurt if a patient chooses not to get the tests the doctor ordered. Other examples of physicians’ quality rating measurements being directly impacted by patient choice or other factors include medication compliance, routine screening exams, weight management, and tobacco cessation.

Physicians also are finding the transition to value-based payment models cost-prohibitive due to: 1) the expansion of these “quality” programs; 2) the vast number of quality measures; 3) the difficulty of deciphering which measures are important; and 4) interpreting quality-data reports in a meaningful way for their practices. The overwhelming number of uncoordinated quality measurement and reporting initiatives across multiple insurance companies must be addressed.

While cigarettes, cigars, and smokeless tobacco (chewing tobacco and snuff) are the most widely used tobacco products, some new products are attracting the interest of minors. Electronic cigarettes or “e-cigarettes” are widely accessible and growing in popularity. Several states have already passed legislation to include e-cigarettes in nonsmoking laws or to restrict the sale of e-cigarettes to minors. TMA is calling on lawmakers to restrict the purchase of e-cigarettes by minors, adopt appropriate regulations for e-cigarettes, and ensure the current smoking prohibitions include e-cigarettes. Physicians are concerned that the use of e-cigarettes by minors could be a pathway to future tobacco use and nicotine addiction.

Texas has long been challenged to produce or recruit enough physicians to keep up with our rapidly growing population. The sheer size of the state’s population is the biggest driver of physician demand. The state’s broad expanse and varied geography and demographics, plus the great attraction for others to move to Texas, result in an ever-increasing demand for physicians and other health care professionals. Over the past two decades, Texas has led the country in population growth.

The convergence of a larger, increasingly aging, and increasingly obese population of Texans represents “a recipe for disaster.” In the United States, approximately 80 percent of all persons 65 and older have at least one chronic condition, and half have at least two. These patients take longer to treat, and the amount of services and care they require grows more and more complex. Diabetes, which causes excess morbidity, premature mortality, and increased health care costs, affects about 1.8 million adult Texans.

A study suggests that exercise can help kids, especially those with A.D.H.D., focus in class.

Texas Medical Association's insight:

Obesity and being overweight contribute to diabetes, hypertension, heart disease, cancer, and stroke. Unfortunately, Texas has a growing obesity crisis. Thirty-seven percent of Texas adults are overweight, while 29 percent are obese — placing Texas among the 20 states with the highest obesity rates. During the past three decades, obesity rates in children have more than tripled. Today, 32 percent of Texas children (aged 10-17) are obese. This not only increases their risk for being overweight or obese as adults, it also puts them at greater risk for chronic disease, a shorter lifespan, and other lifelong health problems. A child who is overweight at age 12 has a 75-percent chance of being overweight or obese as an adult.

Improved physical health in students has been linked to academic success. Conversely, children with obesity are more prone to absences and lower grades. In the United States, students who are physically active at least 60 minutes on most days, play on at least one sports team, or watch fewer than three hours of television per day consistently earn “mostly A’s.” The physical health of our students has been further compromised with the Texas Legislature’s action to reduce the health education requirements for most Texas students.

Electronic cigarettes or “e-cigarettes” are widely accessible and growing in popularity. Several states have already passed legislation to include e-cigarettes in nonsmoking laws or to restrict the sale of e-cigarettes to minors. TMA is calling on lawmakers to restrict the purchase of e-cigarettes by minors, adopt appropriate regulations for e-cigarettes, and ensure current smoking prohibitions include e-cigarettes. Physicians are concerned that the use of e-cigarettes could be a pathway to future tobacco use and nicotine addiction.

[The Associated Press] MIAMI — Health care companies say they're losing millions of dollars that are tied up in appeals because of increasing numbers of Medicare audits. But the rise in the often duplicative audits has failed to reduce Medicare fraud, according to a ...

Texas Medical Association's insight:

RACs are bounty hunters. They receive a healthy commission on every claim they deny.RACs don’t have a medical license. Personnel with little to no expertise in medical care conduct the reviews, which helps to explain why “overpayment determinations” are being overturned at an alarming rate. Only physicians should be allowed to decide whether a physician service was medically necessary.RACs are not held accountable. They should be penalized for erroneous overpayment determinations and should be required to reimburse physicians for the costs incurred in defending against a recovery audit when an appeal is won. According to CMS, the RAC loses 43 percent of the time when a physician or provider appeals a recovery audit overpayment claim. Physicians should not bear the cost of legal and administrative fees to pursue appeals, especially when they win the appeal.

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